Individual provider Active NPI

Jeffrey S Rose, MD

  • Cardiovascular Disease Physician
  • Gig Harbor, WA
National Provider Identifier
1396749701
Registry record updated Dec 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD00022810 Issued in WA
Practice address
4700 Point Fosdick Dr NW
Ste 203B
Gig Harbor, WA 98335-1706
Phone
(253) 857-1130
Fax
(253) 857-1121
NPI assigned
Jun 13, 2005
Last updated
Dec 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00022810 WA
Cardiovascular Disease Physician 207RC0000X MD00022810 WA Primary
Clinical Cardiac Electrophysiology Physician 207RC0001X MD00022810 WA

Addresses

Primary practice location

4700 Point Fosdick Dr NW
Ste 203B
Gig Harbor, WA 98335-1706

Mailing address

4700 Point Fosdick Dr NW
Ste 203B
Gig Harbor, WA 98335-1706
Phone (253) 857-1130

Other identifiers 16

IdentifierTypeStateIssuer
0257325OtherWASTATE L&I
0247344OtherWASTATE L&I
0290111OtherWAL&I
5406ROOtherWAREGENCE HEALTHCARE
1005040MedicaidWA
P00765954OtherWARAILROAD
0245561OtherWASTATE L&I
0249912OtherWASTATE L&I
G8906702OtherWAMEDICARE
0150352OtherWAWA STATE DEPARTMENT OF L&
0245392OtherWASTATE L&I
634841-001OtherWAGROUP HEALTH
8950251OtherWACRIME VICTIM
060065814OtherWARAILROAD MEDICARE
P00826850OtherWARAILROAD
0301000OtherWASTATE L&I

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050802000902 WA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Cardiac ElectrophysiologyPractitioner - Cardiac Surgery 9830127661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Cardiac Electrophysiology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1818 Cole St
Enumclaw, WA 98022-3504
Phone (360) 802-5760

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Internal Medicine CurrentSince Apr 24, 2019 Accepting new patients
Franciscan Medical Group Cardiovascular Disease Past Accepting new patients
Providence Health & Services- Washington Past Accepting new patients
Franciscan Medical Group Past Accepting new patients
Everett Cardiology & Electrophysiology, P.S. Cardiovascular Disease PastSince Jun 15, 2005 Accepting new patients

Locations

9230 Sky Island Dr E
Fl 1
Bonney Lake, WA 98391
Phone (253) 750-6000

1818 Cole St
Enumclaw, WA 98022
Phone (360) 802-5760

3021 Griffin Ave
Enumclaw, WA 98022
Phone (253) 833-6241

4700 Point Fosdick Dr
Ste 203B
Gig Harbor, WA 98335
Phone (253) 857-1130

6401 Kimball Dr
Gig Harbor, WA 98335
Phone (253) 858-4335

Interoperability endpoints

  • Direct secure messaging: jrose44557@fhsce.catholichealth.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1396749701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 POINT FOSDICK DR NW",
            "address_2": "STE 203B",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351706",
            "telephone_number": "253-857-1130",
            "fax_number": "253-857-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 POINT FOSDICK DR NW",
            "address_2": "STE 203B",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351706",
            "telephone_number": "253-857-1130",
            "fax_number": "253-857-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00022810",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD00022810",
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "WA",
            "license": "MD00022810",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0257325",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0247344",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0290111",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE HEALTHCARE",
            "identifier": "5406RO",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1005040",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00765954",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0245561",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0249912",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "G8906702",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE DEPARTMENT OF L&",
            "identifier": "0150352",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0245392",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH",
            "identifier": "634841-001",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIM",
            "identifier": "8950251",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060065814",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00826850",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0301000",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

Verify at the official NPI Registry.